49: Lumbar Spondylolysis and Spondylolisthesis.

Journal of Orthopaedic Surgery and Research of lumbar spondylolysis.

As the understanding of spinal instability and biology of bone healing increases, we will be able to better define the population of patients with spondylolisthesis who would benefit most from lumbar fusion or particular methods of fusion and fixation.

Correction of the listhesis is associated with risk of neurologic injury, both transient and permanent. Some surgeons prefer to fuse the spine in place rather than to reduce the subluxation. In persons with higher-grade spondylolisthesis, use of interbody grafts is associated with a high rate of complications. However, the use of these devices adds to the stability of the spinal segment, helps with the reduction of the deformity, and helps achieve sagittal balance, thus ensuring better outcome.

Spondylolisthesis is generally defined as an anterior or posterior slipping or displacement of one vertebra on another. A unilateral or bilateral defect (lesion or fracture) of the pars interarticularis without displacement of the vertebra is known as Spondylolysis. The pars interarticularis is the posterior plate of bone that connects the superior and inferior articular facets of a vertebral body.

Tosteson.Degenerative Spondylolisthesis: MIS vs.

When spondylosis occurs, lumbar radiculopathy--with pain, tingling, numbness, and muscle weakness--may result. Often, the first signs of lumbar spondylosis are morning stiffness and pain. It's quite common for more than one vertebra to be affected by spondylosis. Since the lumbar spine carries the bulk of the body weight, degeneration of the vertebrae support may be most noticeable with repetitive movements such as bending or lifting.

49: Lumbar Spondylolysis and Spondylolisthesis

Identifying Lumbar SpondylosisDiagnosis of lumbar spondylosis consists of a physical examination, neurological examination (to assess sensation and motor function), imaging studies (such as x-rays, CT scan, or MRI), and possibly discography. Once a diagnosis of lumbar spondylosis is confirmed, a treatment regimen is established. Conservative treatment consists of muscle relaxants, anti-inflammatory medication, and physical therapy. If conservative treatment is unsuccessful in relieving the symptoms, the patient is then referred to a spinal surgeon to determine if surgery is an option.

Lumbar Spondylolysis and Spondylolisthesis

The etiology of spondylolisthesis is multifactorial. A congenital predisposition exists in types 1 and 2, and posture, gravity, rotational forces, and high concentration of stress loading all play parts in the development of the slip.

Do I Have Lumbar Spondylolisthesis or Spondylolysis?

ConclusionAs the spine degenerates with age, arthritis and spondylolisthesis are fairly common problems. Fortunately this does not uniformly result in disabling pain. For those patients that do have pain, a proper course of non-operative treatment can be very successful. For those who have failed this, fusion can be very successful in the right patient.

Lumbar Spondylolisthesis & Spondylolysis Surgery

In degenerative spondylolisthesis, intersegmental instability is present as a result of degenerative disk disease and facet arthropathy. These processes are collectively known as spondylosis (ie, acquired age-related degeneration). The slip occurs from progressive spondylosis within this three-joint motion complex. This typically occurs at L4-5, and elderly females are most commonly affected. The L5 nerve root is usually compressed from lateral recess stenosis as a result of facet and/or ligamentous hypertrophy.

Recent

Degenerative Spondylolisthesis: MIS vs.

Non-operative TherapyTreatment for a degenerative spondylolisthesis is based on the characteristics of the patient’s symptoms. Acute symptoms may sometimes be relieved with 1-2 days of bedrest. In addition, medications such as anti-inflammatories or narcotics can be given to help alleviate some symptoms.

Braces have a minor role in treatment as they can help stabilize the spine. This could be worn for comfort as needed, for a short period of time. Physical therapy is often prescribed to increase back conditioning. Typically when a patient has degenerative spondylolisthesis the muscles in the back have become deconditioned. Muscle strengthening can help by reducing the frequency and intensity of the spasms that occur with degenerative spondylolisthesis. There is also a role for epidural steroid injections to help alleviate any inflammation that may exist.

and spondylolisthesis: surgical versus nonsurgical treatment.

Operative TherapySurgery for degenerative spondylolisthesis is considered absolute only when there is an acute neurologic deficit (significant leg weakness). Typically when there is forward slippage of one vertebra on another there is minimal affect on the nerves. Unfortunately as the slip progresses it can pull on the nerves exiting the spinal canal causing pain, numbness and/or weakness. At this time, consideration should be given to surgery. Otherwise surgery is indicated if the pain continues to progress after all methods of non-operative therapy have been exhausted.

Surgical treatment for degenerative spondylolisthesis requires fusing the slipped vertebrae to the adjacent vertebrae. This will prevent the instability that causes pain. There are many ways that a surgeon can perform a fusion. One method is to take bone from the pelvis (autograft) and place it between the slipped vertebrae. Over time this bone grows in between the two vertebrae and fuses the two bones together, preventing the painful motion. There are reports that have indicated that a fusion is more likely to be successful if instrumentation is added to the procedure. This typically involves placing screws into the pedicles of the spine. The screws are connected by metal rods that hold the adjacent vertebrae together. The screws provide additional support to the spine while the fusion occurs. If spinal stenosis co-exists with the degenerative spondylolisthesis then a decompressive procedure (lumbar laminectomy) may also be performed.

Isthmic vs Degenerative Spondylolisthesis.

Reviews

“ Lumbar spondylosis is often a result of osteoarthritis or bone spurs that form because of aging. Spondylosis, which is the fusing or immobilization of one or more vertebral joints, can result in deformation of the bone structure that houses the spinal nerves. The spinal column is made up of bone, ligament, and cartilage, with a hole for spinal nerves. Spondylosis may affect the facet joints and intervertebral discs on any area of the spine. ”

Spondylosis vs. Spondylolysis vs. Spondylolisthesis - …

Gallery Is it progressive in spondylosis vs spondylolisthesis nature

49: Lumbar Spondylolysis and Spondylolisthesis | …

It is unknown as to why spondylolysis, in some people, becomes a spondylolisthesis and in others it doesn't.

When spondylolysis and spondylolisthesis do cause pain, you may experience low back pain, stiffness, and muscle spasms. You may also have sciatica (pain radiating down one or both legs), or numbness, though this is not common. Leg pain will usually be worse when you stand or walk.